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Biomedical subjects

L Bond

Publications and source records attributed to L Bond.

36 records · Page 2Linked to original sources
PubMed1997

Childhood bacterial meningitis: impact of age at illness and acute medical complications on long term outcome.

This study compared postmeningitic children (N = 130) with grade and sex matched controls (N = 130) selected from target children's schools on measures of intellectual, linguistic, learning, and reading skills. Results showed that children with a history of meningitis are at greater risk for impairment in these areas, with experience of the disease prior to 12 months of age being an important risk factor. Within the postmeningitic sample presence of medical complications was associated with poorer verbal abilities. Finally, a significant relationship was identified between depressed language skills and later educational difficulty, with these findings interpreted with respect to both developmental and neuropsychological principles.

Adolescent↗
PubMed1996

Child Behaviour Checklist classification of behaviour disorder.

OBJECTIVE: The aim of this study was to determine the applicability of the published clinical cut-off scores of the Child Behaviour Checklist (CBCL) for the classification of behaviour disorders. METHODOLOGY: Child Behaviour Checklists were obtained for 1342 subjects newly referred to the six major mental health centres in Melbourne. The normative community sample of 1002 7-, 12- and 15-year-olds was drawn from a school-based asthma prevalence study. RESULTS: The mean total problem T-score for the children referred to mental health centres was 67 and was above the clinical range for all age groups. Using referral to psychiatric services as the gold standard, the sensitivity and specificity of the CBCL using a cut-off of > or = 60, was 77.4 and 83.2%, respectively. This compares favourably with the sensitivity of 68% and specificity of 82% for the American sample. Using a cut-off score of > or = 63, the sensitivity was 70.5% and the specificity was 88.6%. The referred and community samples differed with respect to socio-economic status, family structure and mothers' level of education. Fifty-two per cent of the clinically referred children lived with both parents, compared with 89% of the community sample. CONCLUSIONS: While there are some limitations to this study in terms of both the clinic and community sample, support is provided for the usefulness and applicability of the recommended CBCL cut-off scores in an Australian population.

Adolescent↗
PubMed1996

Risk factors for adverse outcomes of bacterial meningitis.

OBJECTIVE: To identify risk factors for adverse outcomes from bacterial meningitis. METHODOLOGY: From a cohort of 166 children with bacterial meningitis who were studied prospectively, 130/158 (82%) survivors underwent neurological, neuropsychological, audiological and behaviour assessments 5-9 years following their illness. RESULTS: Major adverse outcomes included B/166 (4.8%) deaths and severe neurological, intellectual or audiological sequelae in 11/130 (8.5%) children followed. Another 24 (18.5%) had cognitive, auditory or behaviour disorders. Bivariate analysis found age < or = 12 months, tertiary referral, symptoms > 24 h before diagnosis, seizures, focal neurological signs, deteriorating conscious state in hospital, Streptococcus pneumoniae infection and serum sodium concentration < 130 mmol/L were associated with adverse outcomes. Multivariate analysis showed age < or = 12 months, symptoms > 24 h, seizures after 72 h in hospital and focal neurological signs as independent risk factors. These were present in 18/19 (95%) children with major sequelae, but absent in 9/24 (37.5%) children with minor disabilities. CONCLUSIONS: As minor disabilities following meningitis cannot be predicted, all survivors require assessment during their early school years.

Adolescent↗
PubMed1996

At risk for HIV infection: incarcerated women in a county jail in Philadelphia.

This study presents the results of a needs assessment survey conducted with 66 incarcerated women in a large Philadelphia county jail during the winter of 1993. Results indicated that prior to incarceration, these women engaged in very high risk sexual and drug use behaviors, and had experienced a myriad of other problems that may contribute to their risk for HIV infection. Of the 66 women who participated in the study, over three-fourths had used crack cocaine, nearly one-half had traded sex for drugs and money in the six months prior to incarceration, one-third reported a prior history of injection drug use, and one-half report sexual contact with a male partner who injected drugs. In addition, one-fourth of the study sample had been homeless during the year prior to incarceration, one-half reported a prior history of sexual abuse, three-fourths had been physically beaten by a boyfriend or spouse, and nearly one-half had a prior history of syphilis. Although limited in scope, the results of the study have important implications for developing relevant jail-based HIV risk reduction programs for women. The results provide strong evidence for the need for interventions that address not only the HIV-related risk behaviors of incarcerated women, but also the underlying social problems that contribute to their risk of HIV infection.

Adolescent↗
PubMed1995

Adverse outcomes of bacterial meningitis in school-age survivors.

OBJECTIVE: To determine the outcomes of bacterial meningitis in school-age survivors. DESIGN: Prospective cohort study. SETTING: Teaching pediatric hospital. CHILDREN: During 1983 through 1986, 158 meningitis survivors, ages 3 months to 14 years, treated at a single center were enrolled. Between 1991 and 1993, 130 children, 82% of the original cohort, were evaluated at a mean age of 8.4 years and a mean of 6.7 years after their meningitis. OUTCOME MEASURES: Blinded neurologic, neuropsychologic, audiologic, behavior, and socio-demographic assessments were compared with those from grade- and sex-matched control children. Multivariate analyses adjusted for age at testing and socio-demographic variables. RESULTS: There was a systematic increase in risk of abnormality or poorer functioning for children with meningitis, compared with control children, across all categories tested, which was significant for fine motor function, Intelligence quotient (IQ) scores, and tests of school behavior, neuropsychologic function, and auditory figure-ground differentiation. Eleven children who had experienced meningitis (8.5%) had major deficits (IQ < 70, seizures, hydrocephalus, spasticity, blindness, or severe to profound hearing loss); a further 24 (18.5%) cases and 14 (10.8%) control children had minor deficits (IQ 70 to 80, inability to read, mild to moderate hearing loss, abnormalities in speech discrimination, or school behavior problems). Overall, children who had meningitis were at greater risk (26.9%) for disability. Children with acute neurologic complications had more adverse outcomes than those with uncomplicated meningitis and control children (39% vs 18% vs 11%, respectively). CONCLUSIONS: One in four school-age meningitis survivors has either serious and disabling sequelae or a functionally important behavior disorder, neuropsychologic or auditory dysfunction adversely affecting academic performance. As a group, survivors function less well than their classroom peers, and risk is greatest for, but not confined to, those who had acute neurologic complications. All survivors require careful follow-up, at least until school age.

Adolescent↗
PubMed1995

Positions in labour: a plea for flexibility.

The authors trace the use of birthing stools and their decline as the recumbent position became the predominant one for giving birth. The advantages of upright positions are summarised, supporting the idea that women should be allowed more flexibility and movement in labour and recommending that birthing stools be reintroduced as an option for delivery. Adequate antenatal preparation in the use of different positions, and encouragement from midwives and obstetricians, will help make childbirth a safer, more collaborative and satisfying experience as recommended by the Winterton Report.

Female↗
PubMed1994

Pyoderma gangrenosum associated with paroxysmal nocturnal haemoglobinuria.

A case of pyoderma gangrenosum of the lip occurring in association with paroxysmal nocturnal haemoglobinuria is described. This is an extremely rare association, which has been documented in the literature on only two previous occasions. Pyoderma gangrenosum (PG) is an uncommon ulcerative skin disorder of unknown aetiology. Its clinical appearance is often distinctive, with established lesions consisting of a necrotic ulcer surrounded by a ragged undermined violaceous edge. Lesions are usually painful and are most often found on the lower limbs but can occur on the trunk, head and neck. The diagnosis is essentially clinical as there are no characteristic histopathological changes. Since its original description in 1930, PG has been frequently associated with a number of underlying systemic diseases. Foremost among these are inflammatory bowel disease and inflammatory polyarthritis. The association with haematological disorders is also well recognized, and includes acute and chronic lymphocytic and myeloid leukaemias, polycythaemia rubra vera, myelofibrosis, myelodysplastic syndrome, essential thrombocythaemia, hypogammaglobinaemia, monoclonal gammopathy, multiple myeloma and non-Hodgkin's lymphoma. We report a case of PG occurring on the lower lip of a 26-year-old man recently diagnosed as having paroxysmal nocturnal haemoglobinuria (PNH).

Adult↗
PubMed1994

Miniature field-flow fractionation system for analysis of blood cells.

Field-flow fractionation is an analytical tool that has been historically used to separate species, ranging from molecules to particles or cells several micrometers in size. This technology can effect separation by size, density, charge, or other physical properties, depending on the configuration of the field-flow system. We have developed a miniature field-flow system to analyze cell populations in a small, 125-microns-deep channel 19 cm long. Gravity is used as the primary field to effect separation, and cell analysis is performed in < 20 min. Erythrocytes elute as a single peak when diluted blood is fractionated in this system. Analysis of blood samples from several donors (normal controls and patients with sickle cell anemia) yields erythrocyte peaks with slightly different mobilities (elution times). Peak mobility does not directly correlate with mean cell volume or other standard erythrocyte parameters. Cell density appears to be a key factor in determining cell mobility with this system.

Cell Separation↗
PubMed1993

Oral enoxacin for infection prevention in adults with acute nonlymphocytic leukemia. The Enoxacin Prophylaxis Study Group.

A randomized, double-blind, placebo-controlled trial was conducted in eight hematologic units to determine the efficacy and safety of oral enoxacin for infection prevention in adult patients with acute nonlymphocytic leukemia. One hundred nineteen patients undergoing remission induction or consolidation chemotherapy were enrolled; 62 of them received enoxacin (400 mg orally every 12 h). Patients received antifungal prophylaxis with oral mycostatin (1,000,000 U four times daily) or clotrimazole (1 troche five times daily). Analysis was performed on an intent-to-treat basis. There was no significant difference between groups in race, age, or type and stage of leukemia, but there were more males in the placebo group (P = 0.073 [Fisher's exact test]). Fewer enoxacin patients had gram-negative bacteremia (1 versus 14 [P < 0.001]), gram-negative infection at any site (2 versus 19 [P < 0.001]), or bacterial and/or fungal infection (17 versus 26 [P = 0.056]). There was no significant difference in the number of patients with gram-positive infection at any site (12 versus 16), gram-positive bacteremia (9 versus 10), deep fungal infection (6 versus 2), death (2 versus 3), other antimicrobial therapy required (48 versus 48), therapy with amphotericin B (15 versus 7 [P = 0.105]), any adverse event (45 versus 36), or any study drug-associated adverse events (13 versus 6). Logistic regression confirmed (odds ratios and 95% confidence intervals are given in parentheses) that enoxacin reduced the risk of gram-negative infection (0.07; 0.01 to 0.30), especially gram-negative bacillary bacteremia (0.05; 0.01 to 0.37), without altering the risk of gram-positive bacterial (0.63; 0.26 to 1.5), deep fungal (2.57; 0.47 to 13.9), or Clostridium difficile (1.16; 0.3 to 4.56) infection. The median time to the onset of fever of more than or equal 102.8 F (39.3 degree C) was 32 days for the enoxacin group versus 15 days for patients receiving placebo (P=0.0007 [Wilcoxon test]). In patients with acute nonlymphocytic leukemia, oral enoxacin prevents gram-negative infections, delays the onset of fever, does not alter the incidence of gram-positive or proven deep fungal infections, and is well tolerated.

Administration, Oral↗
PubMed1993

Multianalyte assay system developed for drugs of abuse.

A simple, 10-min immunoassay system has been developed that simultaneously screens for five different classes of drugs of abuse in a urine sample. This system tests for amphetamines, cannabinoids, cocaine metabolites, opiates, and phencyclidine, and each assay has a specific preset cutoff concentration. Accuracy is > 99% for reporting positive or negative results for samples with 200% or 50%, respectively, of the cutoff concentrations of the drugs. Tests of a panel of 96 compounds yielded only three cases of nonspecific reactivity (at a drug concentration of 100 mg/L). Another panel of 12 compounds that could normally be found in urine samples was also evaluated and no interferences were observed. Concordance was > 95% between this system and the comparable automated immunoassays for detecting drugs of abuse. Greater than 98% of GC/MS-confirmed positive samples gave positive results with this assay system.

Autoanalysis↗
PubMed1992

Parent verbal interactions and speech rate: a case study in stuttering.

This single-case study of indirect stuttering treatment is intended to identify variables for further research. The study used post hoc analyses of changes in parent speech variables and changes in the child's stuttering. The analysis was conducted in two parts. Study I examined the relationships between the child's percent syllables stuttered and the parents' speech rates and percentages of nonaccepting statements, interruptions, questions, nonaccepting questions, and talk time. The only parent variable significantly correlated with the child's stuttering was the mother's speech rate. In Study II the child's percent syllables stuttered were subdivided into primary (effortless) and secondary (tense) stuttering. Each category was then correlated with the parent variables examined previously. Results suggested that the parent variables that were significantly related to the child's primary stuttering were not the same as those significantly related to her secondary stuttering. Specific parent variables are suggested for further study.

Child, Preschool↗